Alopecia in women with severe and morbid obesity who undergo bariatric surgery.
Departamento de Nutrición, Facultad de Medicina, Universidad de Chile, Santiago, Chile.
Introduction: Bariatric surgery leads to a significant body weight reduction although it is associated to a higher risk of presenting some nutritional deficiencies. A common complication, little studied and mainly related to zinc deficiency is alopecia. Objectives: To compare the nutritional status of zinc, iron, copper, selenium and protein-visceral in women with different degrees of hair loss at 6 months after gastric bypass or tubular gastrectomy. Methods: The patients were categorized into two groups according to the degree of hair loss: group 1 or mild loss (n = 42) and group 2 or severe hair loss (n = 45). Zinc, iron, copper, and selenium, as well as the indicators of the nutritional status of zinc, iron, copper, and protein visceral were assessed before and after 6 months of the surgery. Results: In both groups there was a significant body weight reduction at 6 months post-surgery (-38.9% ± 16.4%). Patients in group 1 presented a significantly higher intake of zinc (20.6 ± 8.1 vs. 17.1 ± 7.7 mg/d) and iron (39.7 ± 35.9 vs. 23.8 ± 21.3 mg/d.), and lower compromise in the nutritional status of zinc and iron than group 2. However, patients in group 2 had lower compromise in the nutritional status of copper. There were no differences regarding the plasma concentrations of albumin. Conclusions: The patients having lower hair loss at six months after surgery had higher zinc and iron intake and lower compromise of the nutritional status of both minerals.
It is likely that bariatric surgery and crash dieting have quite a bit in common when it comes to the potential for nutritional and metabolic imbalance. Careful nutritional guidance after bariatric surgery is important for maintaining body-health. It would have been interesting to see if those women with increased hair loss post-bariatric surgery had an underlying genetic risk for hereditary hair thinning... That would be a simple cheek swab/DNA test using the HairDX genetic test kit. At Bauman Medical Group, we treat many hair loss patients who are on weight loss programs and we know that good nutrition is an important factor. Often an underlying tendency toward female hair loss is revealed by poor nutrition. Unfortunately, correction of the nutritional state does not always allow the hair to return to 'normal.' Aside from Zinc supplementation in thsese cases, other interventions might include Laser Therapy (LaserCap), Minoxidil (Formula 82M), Viviscal, mega-dose Biotin or hair transplant surgery.
--Alan J. Bauman, M.D.
Diplomate, American Board of Hair Restoration Surgery
Member, International Society of Hair Restoration Surgery